Alcohol - Health Committee Contents

6  Education and information policies

144. In addition to interventions by clinicians to discourage drinking, the Government's Strategy, as we have seen, stresses "the importance of informing and supporting people to make healthier and more responsible choices" through campaigns and the provision of information. The Government told us that this included:[182]

  • public health education campaigns to improve understanding of alcohol units and health risks; and to challenge binge drinking and spread awareness of the consequences; the DH drink prevention programme has an overall budget of £10 million in 2008-09 and consists of a 'units campaign' and a 'binge drinking campaign'.
  • planned campaigns from 2009 aimed at children and their parents; the Department for Children, Schools and Families (DCSF) told us that it was planning a new social marketing campaign from 2009, aimed at young people and their parents, with £12.5 million funding over the next 3 years.
  • The Chief Medical Officer's Guidance on the Consumption of Alcohol by Children and Young People, which will support the DCSF's campaign
  • Labelling: the Government told us that it had come to an agreement with the industry to introduce unit and health information; on labels, it was hoped that the majority of labels by market share would have complied by the end of 2008.
  • Targeted support aimed at those who drink more than double the Government's guidelines, including web-based support and advice and an improved national helpline and an 'innovative pilot' in the north west to target information to 'neighbourhoods, individuals and their families'.

145. Government spending in 2009/10 on alcohol information and education campaigns is £17.6m. Individual Department's expenditure is as follows:[183]

  • DH: £6.85m
  • Home Office: £2m
  • DCSF: £5m
  • DfT: £3.75m

146. In addition, the alcohol industry funds activities to promote sensible drinking. The Portman Group was set up in 1989 by the UK's leading alcohol producers; current members account for the majority of the UK alcohol market. The Group's main role currently is to encourage the industry 'to promote its products responsibly, mainly through the operation of the Code of Practice on the Naming, Packaging and Promotion of Alcoholic Drinks'.[184]

147. The Government set up the Drinkaware Trust, in 2006. Its trustees include health professionals, representatives of the drink and retail industry and others. It is funded producers and retailers. In 2006 it took on the Portman Group's remit for consumer education. During the inquiry the Trust announced a social marketing campaign, spending up to £5m per year for five years, to help tackle binge drinking.

148. Many witnesses were critical of the Government's and industry bodies' information and education measures. The BMA stated that the disproportionate focus upon, and funding of, public information and educational programmes must be redressed.[185] Specific criticisms were:

  • the programmes have been shown to have little impact on changing behaviour. Professor David Foxcroft, a chartered psychologist specialising in the science of prevention, told us that

a number of different studies had shown that traditional types of alcohol education in schools, just telling people about the risks associated with alcohol...are ineffective. I believe that this is the message put across by the WHO report.[186]

Dr Peter Anderson added:

There is very good scientific evidence that information campaigns and education campaigns on their own do not change behaviour. These campaigns have to be done in association with policy changes or done to help support policy changes. Just providing information is not going to change people's behaviour.[187]

  • The sums spent by Government and the Drinkaware Trust are, as Professor Ian Gilmore, President of the Royal College of Physicians, highlighted, insignificant compared with the massive amounts of money spent by the industry; Dr Anderson suggested that public education programmes could only compete if advertising by the drinks industry was reduced to level the playing field.[188]
  • campaigns funded by the alcohol industry can backfire, reinforcing heavy drinking due to creating a more favourable impression of the industry;[189] we were told:

The limited available research has shown that industry funded educational programmes tend to lead to more positive views about alcohol and the alcohol industry.

  • the campaigns are not very good; Sainsbury thought that there was considerable room for improvement, as we discuss below.

149. Finally, there is concern that education and information campaigns are emphasised and promoted by the industry because it knows they do not work. The British Society of Gastroenterology and the British Association for the Study of the Liver informed us:

According to the DH, 25% of the UK population are hazardous or harmful drinkers, but this minority consumes 75% of alcohol sales. This phenomenon is well described in other countries and means that the alcohol production and retail industries rely on hazardous and harmful drinkers to supply three-quarters of their profitability. One therefore has to question the motivation of the alcohol industry to reduce alcohol related harm, and their central role in policy making so far.[190]

150. Nevertheless, while the education and information campaigns were much criticised, the critics did not believe that they should be dropped altogether; rather it was thought that while not effective on their own, they could be a useful part of a wider strategy of which they were an element. Dr Anderson told us:

Providing information and education is important to raise awareness and impart knowledge, but, particularly in a living environment in which many competing messages are received in the form of marketing and social norms supporting drinking, and in which alcohol is readily accessible, do not lead to changes in behaviour. Reviews of hundreds of studies of school-based education have concluded that classroom-based education is not effective in reducing alcohol-related harm. Although there is evidence of positive effects on increased knowledge about alcohol and on improved alcohol related attitudes, there is no evidence for a sustained effect on behaviour.[191]

The provision of good information does not change behaviour, but can justify and lead people to respond better to more powerful interventions such as raising prices. Dr Anderson added:

warning labels are important in helping to establish a social understanding that alcohol is a special and hazardous commodity.[192]

151. Moreover, it is argued that people have a right to information about a dangerous substance such as alcohol.

152. Other witnesses made suggestions for improving both the campaigns and the information put on labels, arguing for more focus on:

  • the number of units contained in alcohol containers; the RCP described a significant lack of knowledge amongst the general public about guidelines relating to alcohol:

Many people underestimate the amount of units they are drinking. A YouGov survey of 1,429 drinkers in England found more than a third did not know their recommended daily limit—2-3 units for women and 3-4 for men.[193]

Similarly, it is not widely known that there are about 9 units in a bottle of 13% wine, which means that a woman drinking half a bottle of wine a day is consuming over 30 units a week, which is more than twice the recommended levels.

  • The need to have a couple of days each week alcohol-free.
  • The health risks, perhaps including labels such as 'Alcohol causes cancer, liver disease and other illnesses'.

153. Unfortunately, progress in labelling is proceeding painfully slowly. In May 2007, the Department reached a United Kingdom-wide voluntary agreement with the alcohol industry to include specified unit and health information on alcohol labels. The Government made clear their expectation that the majority of labels should be covered by the end of 2008. In November 2009 the Government expected to be able to publish shortly the results of independent monitoring from samples taken in April 2009. The Government was about to look at whether a majority of labels were covered by the expected information and whether the content was consistent with the 2007 voluntary agreement. The Government stated that

If we find that most labels are still not complying with the voluntary agreement, we will consider what action we can take to improve compliance, including using existing powers under the Food Safety Act to make this a mandatory requirement. We believe that consumers have a right to consistent, agreed information on at least the large majority of alcohol labels, to enable them to assess their intake of alcohol and to relate this to the Government's guidelines.[194]

Conclusions and recommendations

154. Better education and information are the main planks of the Government's alcohol strategy. Unfortunately, the evidence is that they are not very effective. Moreover, the low level of Government spending on alcohol information and education campaigns, which amounts to £17.6m in 2009/10 makes it even more unlikely they will have much effect. In contrast, the drinks industry is estimated to spend £600-800m per annum on promoting alcohol.

155. However, information and education policies do have a role as part of a comprehensive strategy to reduce alcohol consumption. They do not change behaviour immediately, but can justify and make people more responsive to more effective policies such as raising prices. Moreover, people have a right to know the risks they are running. We recommend that information and education policies be improved by giving more emphasis to the number of units in drinks and the desirability of having a couple of days per week without alcohol. We also recommend that all containers of alcoholic drinks should have labels, which should warn about the health risks, indicate the number of units in the drink, and the recommended weekly limits, including the desirability of having two days drink-free each week. We doubt whether a voluntary agreement would be adequate. The Government should introduce a mandatory labelling scheme.

182   The information below is taken from AL 01 Back

183   Source: Department of Health Back

184   Ev 123 Back

185   Ev 22 Back

186   Q 614 Back

187   Q 29 Back

188   Q 34 Back

189   Q 29 Back

190   Ev 68 Back

191   AL 58 Back

192   Ibid. Back

193   Ev 159 Back

194   HC Deb, 9 November 2009, c107W Back

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